{include file="insurant_common/insurant_head"}
    <div class="wraper-box">
      <div class="container">
        <div class="main ovh">
          <div class="menu left">
            {include file="insurant_common/insurant_left"}
          </div>
          <div class="menu-content left">
            <div class="content-title">
              <p><span class="red name">填写相关资料</span></p>
            </div>
            <div class="msg-tip">*以下提货信息，将作为拍卖后提货的法律依据</div>
            <div class="step-box">
              <div class="active">设保留价</div>
              <div class="active">看货信息</div>
              <div class="active">提货信息</div>
              <div class="">收款信息</div>
              <div class="">递交委托书</div>
            </div>
            <div class="form-box">
              <div class="form-content">
                <div class="form-item textarea">
                    <label class="vtt">提货是否需要支付其它费用:</label>
                    <label><input type="radio" name="a" class="hide"> <i><b></b></i>是</label>
                    <label><input type="radio" name='a'class='hide'> <i><b></b></i>否</label>
                </div>
                <div class="form-item textarea">
                  <label class="vtt"></label>
                  <textarea type="text" placeholder="请详细填写需支付的费用，以免产生纠纷"></textarea>
                </div>
                <div class="form-item textarea">
                  <label class="vtt">提货详细说明:</label>
                  <textarea type="text" placeholder="请填写受损原因"></textarea>
                </div>
                <div class="form-item">
                  <label>提货地址:</label>
                  <input
                    type="text"
                    placeholder="请选择省市区"
                    class="address"
                  />
                  <input
                    type="text"
                    placeholder="详细门牌地址"
                    class="address-detail"
                  />
                </div>
                <div class="form-item">
                  <label>联系人:</label>
                  <input type="text" placeholder="请填写货品名称" />
                </div>
                <div class="form-item">
                  <label>手机号:</label>
                  <input type="text" placeholder="请填写数量与规格" />
                </div>
                <div class="form-item">
                  <label style="width:100px">备用联系人手机号:</label>
                  <input type="text" placeholder="请填写数量与规格" />
                </div>
              </div>
              <div class="form-footer">
                <div class="step-btn-box">
                  <div class="pre-btn">上一步</div>
                  <div class="next-btn">下一步</div>
                </div>
              </div>
            </div>
          </div>
        </div>
      </div>
      {include file="common/footer"}